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Home My WebLink About0130 WINTER STREET UNIT BLDG 1 UNIT 1 - Health 130-WINTER'5T., HYANNIS A= SEWE 44 1 FC i ,ry ....:....... Hazardous Materials Inventory Sheet Checklist �hysical ate Street Address-Check database to ensure it exists Working Phone Number Actual Amounts -( ie. gas being used to fuel machines,thinner to clean brushes all count as hazardous materials) cif Storage Information- location of storage, how long is storage for? If none, note that. 1 Disposal Information -where and who? If none, note that. Applicant Signature- understand what is listed and noted Staff Initial -any questions, know who to ask Vehicle Washing/Rinsing? -provide a vehicle washing policy and explain it- note that it was given L/Attach the Business Certificate with your sign off and comments "The inventory form should explain what the business consists of and the procedures they are doing. Notes need to be left to explain what you discussed with them. Hazardous Materials Inventory Sheet Checklist t Date Physical Street Address-Check database to ensure it exists —�—Working Phone Number _Actual Amounts -( ie. gas being used to fuel machines, thinner to clean brushes all count as hazardous materials:-no blanks) Storage Information - location of storage, how long is storage for? !$nor+n, note that. Disposal Information -where and who? If none, note that. Applicant Signature - understand what is listed and noted Staff Initial -any questions, know who to ask Vehicle Washing/Rinsing? -give a vehicle washing policy and explain it Attach the Business Certificate with your sign off and comments "The inventory form should explain what the business consists of and the procedures they are doing.__Notes need to be left to explain what you discussed with them. YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates [cyst$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME In town (which you, must do by M.G.L.-it does not give you permission to operate.) You must-first obtain the necessary signatures on this form at 200 Main St., Hyannis, - , 02601 (Town* and et'the 6'usiness Certificate that is Hyannis, MA ) Town Clerk's Office .1st FI. 367 Ma in St. ( g e o Y i t ,form to _ he com completed o_ h ,Take t it d requ b e y law. , DATE Fil iri'pl se Nal,A* qiwo Ali APPLICANT'S YOUR NAME/ BUSINESS YOUR HOME ADDRESS: tA 'll' TELEPHONE # Home Telephone Number h N ME OF CORPORATIO .. :.:,-�,..... ....,.....,.... . . :..... � . . . ,..... -:7YPE.. F�6USIIVE55:: • NAME.OF NEW BUSINESS, .. r •� ;,iE�.,?: •f.r": 1 . .1..... .. y'; —=k D. vh YES " - CCU ..:AT 5 IS A HO E O P . .I. N � N , -•:".: -� _ <.: . :, 4_ 8 ,.. - :ADDREOSBl�51NESS..,...:.:. ,: ..:.. 'IVI X1 ... . AR CEL,N,UIViB�R When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town'of Barnstable. This form is intended to assist you in obtaining the information you.may need. You MUST GO TO 200 Main St.'- (corner of Yarmouth Rd. & Main Street) to.make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSION R'S OFFICE This individuaiha bel formed y rm req 'f ements that pertain to this type of busIMST COMPLY WITH HOME OCCUPA iOt�•. '. RULES AND REGULATIONS`: FAILI,`.RE.TO .' / Auth rize Si nat[7re**, CQMFi.Y MAY RESULT IN. FINES. . COMMENTS:C 2. BOARD OF HEALTH _ This individual has'' i farmed er requi ants that pertain to this type of business. Authorized Sin ure** 8 MUSI"COMPIY VVyTH ALL COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY] f` °�•� This individual has been informed of the licensing requirements that pertain to this type of business. l Authorized Signature* nvlsly dvl ,lA r Dater/of"I,-W6 TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: 0 U BUSINESS LOCATION: INVENTORY MAILING ADDRESS: 0 Cih OTAL AMOUNT- TELEPHONE NUMBER: �6 — CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMB R: MSDS ON SITE? TYPE OF BUSINESS: INFORMATION / RECOMMENDATI S: Fire District: Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month re uires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum • Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED - Degreasers for engines and metal Printing ink Degreasers for driveways &garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous(please list): Metal polishes Laundry soil &stain removers (including bleach) Spot removers&cleaning fluids_ (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Sign u Staff's Initials—6`� YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$%00 for 4 years)..A business certificate ONLY REGISTERS YOUR DAME in town (which you must do by M.G.L.-it does not give you permission�to operate.) Business Certificates are available at the Town Clerk's Office, 'I"FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) DATE:041 0/4 11 _Q n Fill in please: ram: APPLICANT'S YOUR NAME/S: G ✓a.1 C OAOtki 2A-5 Is i t ' IU�1"'Miff"' 1� BUSINESS YOUR HOME ADDRESS: I �'�: Y1 S �' WU Zk >�n i S- f+1 t Icu ,1 0 aGV/� l r Ak1 1:tSf raHl7:�� I (71�k TELEPHONE # Home Telephone Number 50� -? . 4 NAME OF CORPORATION- NAME OF NEW BUSINESS ' ; A�1 emo e.TYPE OF BUSINESS �� }-e rz_ IS THIS A HOME OCCUPATION? NO 04� ADDRESS OF BUSINESS ?, MAP/PARCEL NUMBER:Jy�- ! h (Assessing) When'starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operai6e7your business in this town. 1. BUILDING COMMISSIONER'S OFFICE r This individual has been informed of any permit requirements that pertain to this type of business. J Authorized Signature *.* COMMENTS: i 2. BOARD OF HEALTH This individual ha-s been infor o t e p r it req iremants that pertain to this type.of business. Authorized Signature* M TCOMPLYWITHALL COMMENTS: rREGULATIONS 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) . This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: �s / ! I TOWN OF BARNSTABLE Date:a�/ vq TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: (Pa wbvA Pay Vq-�'►'yt->, a v-clr- BUSINESS LOCATION: 130 wi 14- •t o, r)»1'c --m !" INVENTORY MAILING ADDRESS: , Y- IA ont S r77A o a6OI TOTALAMOUNT: TELEPHONE NUMBER: 609 �9 1 CONTACT PERSON: E fg r0 EMERGENCY CONTACT TELEPHONE NUMBER: 5053 360 -7 S D `7 MSDS ON SITE? TYPE OF BUSINESS: '-Po<i Yy G-- INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The board of health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes (J Road salts (Halite) Hydraulic fluid (including brake fluid) 0 Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED 4J (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) 0 Diesel Fuel, kerosene, #2 heating oil n ❑ NEW ❑ USED Miscellaneous petroleum products. grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink V Degreasers for driveways &garages 0 Wood preservatives (creosote) 0 Caulk/Grout o Swimming pool chlorine Q Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible 0 Car wash detergents 0 Leather dyes Car waxes and polishes 13 Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, •� Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers r3 hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes Laundry soil &stain removers (including bleach) Spot removers &cleaning fluids (dry cleaners) �J Other cleaning solvents Bug and tar removers 0 Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials Hazardous Materials Inventory Sheet Checklist Date Physical Street Address-Check database to ensure it exists ��Working Phone Number ,/ Actual Amounts -(.ie. gas being used to fuel machines,thinner to / clean brushes all count as hazardous materials-no blanks) J Storage Information -location of storage, how long is storage for? JIf none,note that. Disposal Information -where and who? If none, note that. Applicant Signature -understand what is listed and noted Staff Initial any questions, know who to ask Vehicle Washing/Rinsing? -give a vehicle washing policy and explain it Attach the Business Certificate with your sign off and comments "The inventory form should explain what the business consists of and the procedures thev are doind. Notes need to be left to explain what you discussed with them. YOU WISH TO OPEN A BUSINESS? / For Your Information: :Business certificates [cost$30.00 for 4 years A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission t6 operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and ;et the Business Certificate that is required by law. DATE: I U Fill in please: APPLICANT'S YOUR NAME/S:_flE BUSINESS YOUR HOME ADDRESS: 13 o vJ i tJT6e, Sri- B 1; Sob-�So -iao3 ` TELEPHONE: # Home Telephone Number 509 NAIVE OF CORPORATION~-° NAA OF NEW BUSINESS GA5fl Lr N' 69 i'CeS TYPE OF,BUSINESS C.LG(at�;tJC> SER,�ic_IC IS THIS XHOME OCCUPATION? YES NO ADDRESS OF BUSINESS �3 vJ' E M mx1 ,—MAP/PARCEL NUMBER (Assessing) . When starting a new business there are several things you must do in order to be in compliance with the rules.and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - [corner of Yarmouth Rd. & Main Street] to make sure you have the appropriate permits and licenses required to legally operate your us ess in this town. 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to:this type of business. Authorized Signature* COMMENTS: 2. BOARD OF HEALTH This individual as be_form-ed of pei uirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual h1teen i rmed of I' n requirements that pertain to this type of business. Authorized Signature** COMMENTS: I i Date: TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON—SITE INVENTORY a NAME OF BUSINESS:LA5A?�11LAOcA GLEAOi►`1(Y SEiZU e �i✓5 BUSINESS LOCATION: 1_3 o �6 -� � R. 5+ # A NU ANNt5 INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: 60 8 - -%8 O - 1903 CONTACTPERSON: IBEAF-1-6 F60,e)eCA EMERGENCY CONTACT TELEPHONE NUMBER: ILL 4 31 - 1103 MSDS ON SITE? TYPE OF BUSINESS: Lk CA(\Jit\_)G SERA f CIE5 INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: Last shipment of hazardous.waste: Name of Hauler- Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous materials use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed/Maximum Observed/Maximum Antifreeze (for gasoline or coolant systems) _ Misc. Corrosive NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil NEW USED Misc. petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Misc. Combustible 4' Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt & roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (inc. carbon tetrachloride) NEW USED Any other products with "poison" labels Paint &varnish removers, deglossers (including chloroform, formaldehyde, Misc. Flammables hydrochloric acid, other acids) Floor &furniture strippers Other products not listed which you feel '4, Metal polishes may be toxic or hazardous (please list): Laundry soil & stain removers (including bleach) Spot removers & cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: ,\ (O V /r Mail To: BUSINESS LOCATION: l3 0 Board of Health MAILING ADDRESS: Town of Barnstable P.O. Box 534 TELEPHONE NUMBER: 501F_> r3��g Hyannis, MA 02601 CONTACT PERSON: `�w l\ EMERGENCY CONTACT TELEPHONE NUMBER: Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities to`ta5sg, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO V This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Quantity/Case Quantity/Case Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business Z (� Q��FtNET06` TOWN OF BARNSTABLE OFFICE OF BAIL MASL BOARD OF HEALTH rua 0,59. ` 367 MAIN STREET HYANNIS, MASS. 02601 February 24, 1988 Winterset East Trust Association c/o 'Joseph Rodriques P.O. Box 2366 Hyannis, MA 02601 Dear Mr. Rodriques : NOTICE TQ ABATE VIOLATIONS QE 1a OR 410 , 00 , STATE SANITARY CODE, MINIMUM STANDARDS U FITNESS M$ HUMAN HABITATION The properties owned by you located at -13_0-Winter Stye=et, Hyannis , Massachusetts , was inspected on February--2-2, 198-8, by Donna Miorandi, Health Inspector for the Town of Barnstable, because of many complaints. The following '- violation of 105 CMR 410. 00, State Sanitary Code, Minimum Standards of Fitness for Human Habitation still exists : REGULATION 410, 602 LAI =d REGULATION 410, 750 (I) : Accumulation of rubbish consisting of many trash bags , including many old newspapers, paper cups, bottles, cans , cardboard pieces and, plastic remnants on ground scattered around the locked dumpster. There are also many food packages, including food debris scattered throughout the property. This violation is a condition deemed to endanger or impair the health or safety of the public and, shall be removed within twenty-four (24) hours . You may request a hearing before the Board of Health if written, petition requesting same is received within seven (7) days after the date the order is served. However, these violations must be corrected within twenty- four (24) hours , regardless of any request for a hearing. Non-compliance could result in a fine of $500 . Each day's failure to comply with an order shall constitute a separate violation. 776-a7q � r' vwI r F You are also subJect to a ticket citation for each day that ..violations are observed. There is an automatic $25 . 00 fine, per day. Tickets will be - issued daily 'until violations are corrected. PER ORDER OF THE,,BARNS ABLE BOARD OF HEALTH Thomas A. McKean Acting Director of Public Health I Date: 0 Oct 0 l TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: I"C `�'��(� C LA-SS C® BUSINESS LOCATION: (/J t r,�ke 3 /�.- Mail To: Vol .MAILINGADDRESS: � I 2� - � �N� !rl Board of Health TELEPHONE NUMBER: 569 --Iq 0• ?Gf)2 Town of Barnstable CONTACT PERSON: A-�a� GG` P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: Ste ) �`�Q 4712-1 Hyannis, MA 02601 TYPE OF BUSINESS: Does your firm store any of toxic or hazardous materials listed below, either for sale or for you own use? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: It m 1 in ( 0mo 0,1M n(1MJInE TELEPHONE: %m LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity Antifreeze(for gasoline or coolant systems) Drain cleaners NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants i Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ' NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners (including chloroform, formaldehyde, Floor & furniture strippers hydrochloric acid, other acids) Metal polishes Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluidsQ_ (dry cleaners) (,y� Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS